“Latest Stem Cells News”

In a ray of hope for millions of leukaemia patients, American scientists have claimed to have developed a technique which multiplies the small number of stem cells in the donor blood, making it much more potent for the treatment of the fatal disease.

It also eliminates the need for a matching donor, whose bone marrow is usually transplanted to the patient, according to a study which appeared in the journal Nature Medicine. Traditionally, there was always a risk that the patient’s body may reject the new cells from a donor.

(…) Participation in this drive and thus registration with the National Marrow Donor Program consists of simple swabs of the cheeks using Q-tips for a DNA test. DNA information is entered into this lifesaving donor program database. If a potential donor is identified as a potential match for David or someone else in need, he/she will be contacted by the donor program to have a small amount of blood drawn for lab testing.

If that person is then confirmed as a match, he/she will be asked to provide stem cells through a simple donation procedure where blood is taken from one arm through a needle and run through a machine, which separates the stem cells from the blood, and returned into the other arm.

Myelodysplastic Syndromes (MDS) are a group of diseases that affect the bone marrow and blood. Some types of MDS are mild and easily managed, which other types are severe and life-threatening. Mild MDS can grow more severe over time. It can develop into a fast-growing, severe leukemia called acute myelogenous leukemia. Stem cell transplant is the only treatment that can cure MDS.

In this treatment, the patient receives high-dose chemotherapy and/or total body irradiation to kill the cells in the bone marrow (including the abnormal bone marrow cells). The patient would then receive new functioning blood-forming stem cells harvested from the donor (…)

from http://www.nj.com/warrenreporter/index.ssf/2009/11/centenary_college_to_hold_stem.html

A breakthrough was achieved recently in the case of an 18 year old boy, a case of advanced stage of Aplastic anemia where stem cells of not one but three donors were used to treat him. This spectacular feat was achieved by the doctors at The Netaji Subhash Chandra Bose Cancer Research Institute (NSCBCRI) Kolkata.

18 year old Aman, student of class 12, fainted in school. He was diagnosed for Aplastic Anemia, a disorder where the bone marrow stops producing red blood cells and platelets. He was treated in many hospitals, but no amount of blood transfusions or ‘immuno-suppressant’ medication could help.

Dejected and depressed, Aman’s parents had almost lost their son when they happened to read a news report by chance. The doctors at NSCBCRI had successfully conducted an SCT to treat Aplastic anemia. . “I wanted to live on, and my parents saw a ray of hope, ”said Aman.
With recent advances in medicine the use of stem cells have been very effective in treating Diabetes milletus, Parkinson’s diseases, cancer, leukemia and Aplastic anemia .

They have been very effective in Bone marrow transplantation
Aman was rushed to Kolkata, but by then his condition had deteriorated. The doctors realized that only a multiple- unit SCT could save him. Overruling the risks they conducted the transplant which took three days.

With 50% chances of risk involved in a single unit SCT, the doctors had a bigger risk at hand, but a similar case conducted successfully in Seattle gave them the courage.
Today Aman Khandelwal is recouping. Thanks to the courage, confidence and competence of the doctors who treated upon him.

from http://www.beviga.com/1401/stem-cell-transplant-a-miracle/

Fondazione IRCCS Istituto Nazionale Tumori di Milano

Methods to provide safer stem cell transplants to individuals who are not completely compatible with the donor are being developed. Encouraging results have come from a post-transplant cellular therapy, which strengthens the immune system against viral infections and tumors, developed for the first time at the National Tumor Institute (INT) in Milan. The INT conducted the first phase I-II study in the world, published in ‘Blood’, whose main objective was to assess the use of a low dose radiochemotherapy, followed by low dose post-transplant infusions CD8-depleted donor lymphocytes after a 50% compatible hematopoietic stem cell transplant.

The objective of the study was to reduce transplant toxicity and improve immune system function after the transplant to reduce mortality due to infections and relapses. Stem cell transplants from fully compatible donors (HLA-identical) are an option for many individuals with blood-borne cancers. However, only 50-60% of these patients are able to find a fully compatible donor in their families or on the international donor registry. For leukemia and lymphoma patients with a high risk for early relapse who are not able to find an identical donor, the only concrete alternative is a transplant from a 50% compatible family donor (haploidentical donor) or umbilical cord stem cell transplants for child or low weight patients.

In the past, the use of partially compatible donors was prevented by severe side effects. New strategies to improve results are increasingly necessary. Twenty-eight adult patients affected by advanced hematological neoplasias who had no other alternative treatment in order to survive took part in the study. Twenty-four of the patients were suffering from lymphoma and four from acute leukemia.

Transplant-related mortality after two years was reduced from 40-50% to 25%. The two-year global survival rate was 44% with a better result for patients with chemosensitive diseases (2-year survival rate of 75%).
On the whole, 54 CD8 depleted donor lymphocyte infusions were performed on 23 patients, using three different doses of cells with the objective of defining which dose favored an efficient reconstitution of immunity against infective agents and residual tumor cells, reducing the probability of inducing aggressive immune responses against the recipient. The infusions were well tolerated by the patients and did not reduce the transplant from taking root and did not induce acute toxicity.

Mesenchymal stem cells are present in placental blood and could represent the new frontier for tissue and organ regeneration. The cells were identified at the cell factory at Milan’s Policlinico Hospital and will be the subject of a meeting on mesenchymal stem cells organized by the Milan hospital.

Isolated and preserved in the Milan biobank for the first time for use in future treatments, the cells come from blood that is collected at birth. Plasma that has been used for transplants in patients with serious diseases like leukemia and lymphoma and represent a potential reserve of mesenchymal stem cells, which are the foundation of regenerative medicine.
The purification procedure, developed by researchers from the research and development lab of the ‘Franco Calori’ Cell Factory at the Policlinico Hospital, led by Lorenza Lazzari, requires placental blood donations to be processed within hours of collection. Purified and cultivated mesenchymal stem cells are then tested further with various animal tissue regeneration models.

These cells have been used experimentally on acute kidney damage in collaboration with Giuseppe Remuzzi’s group of the Mario Negri Institute in Bergamo. “With placental blood,” says Lazzari, “we hope to be able to repair bone, regenerate livers and kidneys, and operate in complex repair processes for other important organs and systems like the heart and nervous system.”
At the meeting, FIRST (the forum of Italian researchers on mesenchymal and stromal stem cells), the Italian group on mesenchymal stem cells, chaired by Lazzari with Massimo Dominici of the University of Modena as Vice-President, will be presented.

The extensive research on stem cells has revolutionised the way life-threatening diseases like leukaemia and aplastic anaemia can be treated.
But there are several steps before these diseases can be treated using stem cells.

To begin with, the Human Leukocyte Antigen (HLA)-typing of the patient is done. Doctors then get into the process of finding a matched donor from the computerised list made available to them by National Marrow Donor Programme (NMDP), U.S., and New York Cord Blood Bank.
If registration of potential bone marrow donors has been in place for a long time, the emergence of a number of cord blood banks, both public and private, which store the stem cells has gone a long way in helping doctors.

Finding a match is just the first step. However, it takes at least three months to procure matched bone-marrow stem cells. It takes just two weeks in the case of cord blood stem cells.
The three-month waiting period in the case of bone marrow arises as locating the matched donor very often becomes difficult.

It requires a minimum of one to three working days to import the stem cells once the match has been found.
“We transfuse blood and platelets to aplastic anaemia patients to sustain them till such time matched stem cells are located, procured and transplanted,” said Dr. Revathy Raj, Consultant Paediatric Haemato Oncologist, Apollo Speciality Hospital, Chennai. “In the case of leukaemia, patients undergo a cycle of chemotherapy in the interim period.”

An important point worthy of mention is that the bone marrow donor is not required to come to the hospital where the patient is, but rather could go to a nearest hospital in the U.S. to donate his stem cells.
In India there are not enough registered bone marrow donors, nor are there proper facilities to harvest bone marrow. Hence the bone marrow cells have to be obtained from organisations like NMDP. The lack of adequate number of donors also results in very slim chances of finding a match in India.

India fares better in the case of cord blood banks. India has two public banks — Reliance in Mumbai and Jeevan Stem Cell Bank in Chennai. But even these banks have only a handful of units. This makes the chances of finding a match very remote.
Though there are a good number of private cord blood banks in the country, they are of little use to the public. Stem cells banked in these places are made available only to the immediate relative of the donor.

from The Hindu